Representations of nurses regarding sexuality of women treated for breast cancer in Brazil

How do nurses and midwives perceive their role in sexual healthcare?

Background

Nurses and midwives role in sexual healthcare is essential to help patients, particularly women, ensure a satisfactory sexual wellbeing. Yet, these professionals often overlook this aspect of patients’ health. Little is known regarding nurses and midwives’ attitudes, views and experiences concerning sexual healthcare. Using a naturalistic inquiry approach, this qualitative study was conducted to overcome this limitation and gain insights into nurses and midwives' role in the delivery of sexual healthcare.

Methods

A purposive sample of nurses and midwives was chosen from different clinical sites. Data generated by focus group discussions were were analysed using the Framework Analysis while adopting different strategies to ensure rigour. The study aligns with the consolidated criteria for reporting qualitative research checklist.

Results

Five themes illustrated the participants’ views and experiences. These are: ‘Perceptions of sexuality’, ‘Appreciating the discussion around the individuals' sexual issues’, ‘Muting the discussion around the individuals’ sexual issues, ‘Coping with embarrassment’, and ‘Promoting nurses’ and midwives’ roles sexual healthcare’. Nurses and midwives discussed the importance of sexuality in the couple's life. They reported controversial views and highlighted many challenges that make them reluctant in playing an efficient role in sexual healthcare. They discussed many suggestions, mainly getting a solid sexual health education to become better equipped to meet patients’ sexual health needs.

Conclusion

Findings are critical to empower nurses and midwives, break the barriers in discussing sexual healthcare and integrate this aspects of care more actively and confidently in daily practice.

Câncer de mama e homossexualidade feminina

Devido aos avanços dos tratamentos oncológicos, a sobrevida das pacientes com neoplasias mamárias tem aumentado significativamente, o que impõe a necessidade de compreender seus aspectos psicossociais. Diferenças de gênero e orientação sexual favorecem a ocorrência de desigualdades dentro dos serviços de saúde. Este estudo teve por objetivo analisar a produção científica nacional e internacional sobre variáveis relacionadas à saúde de mulheres lésbicas com câncer de mama. O levantamento bibliográfico foi realizado a partir das bases LILACS, PubMed, CINAHL e PsycINFO. Foram selecionados 20 artigos publicados entre 2007 e 2017. A análise permitiu delinear os temas: repercussões físicas e psicológicas do tratamento, enfrentamento, riscos de morbidade e mortalidade, qualidade de vida, menopausa e estudos de base populacional. A literatura explora de que modo a doença e o tratamento impactam de forma diferenciada a qualidade de vida de mulheres lésbicas acometidas por câncer de mama. Esse conhecimento é fundamental para subsidiar um cuidado sensível às necessidades dos segmentos minoritários da população.

Healthcare professional perceived barriers and facilitators to discussing sexual wellbeing with patients after diagnosis of chronic illness: A mixed-methods evidence synthesis

OBJECTIVES

To explore healthcare professional perceived barriers and facilitators to discussing sexual health and wellbeing with patients after diagnosis of chronic illness.

METHODS

Five databases were searched and included data were synthesised using a meta-ethnographic approach. Confidence in findings was assessed using the GRADE-CERQual framework. Searches, extraction and quality assessment procedures were conducted independently by at least two authors.

RESULTS

Concepts extracted from 30 included studies were used to develop a conceptual framework based on five overarching themes. These were [1] individual and societal attitudes to sex and sexual wellbeing [2], patient specific factors [3], organizational and professional factors [4], strategies to overcome barriers in practice and [5] perceived training needs. Healthcare professionals acknowledged the importance of discussing and providing support for sexual wellbeing needs, but recognized it is not routinely provided.

CONCLUSIONS

While patient specific factors and organizational issues such as lack of time were frequently identified as barriers, intra-personal and social perceptions appear to have the strongest influence on healthcare professional perspectives.

PRACTICE IMPLICATIONS

Brief education and tools to support healthcare professionals to have effective conversations with patients are required. These should address social barriers, normalise sexual issues, and support healthcare professionals to initiate discussions around sexual concerns.

Idosos em Tratamento Quimioterápico: Relação entre Nível de Estresse, Sintomas Depressivos e Esperança

RESUMO A prevalência do câncer entre idosos tem aumentado nas últimas décadas. O tratamento oncológico pode acarretar aumento dos níveis de estresse e depressão. Nesse cenário, a esperança tem sido definida como um dos recursos relevantes de enfrentamento. Este estudo teve por objetivo analisar a relação entre estresse, sintomas depressivos e esperança em idosos submetidos a tratamento quimioterápico. Trata-se de um estudo quantitativo, descritivo e transversal com amostra não-probabilística de 123 idosos vinculados a um hospital geral público terciário do interior do Estado de São Paulo. Os resultados mostram que os idosos apresentavam elevados níveis de estresse percebido e de esperança; 71,5% não manifestavam sintomas depressivos. Níveis de estresse e esperança foram correlacionados negativamente, assim como sintomas depressivos e níveis de esperança, sugerindo que a esperança pode ter efeitos benéficos sobre o estresse e depressão.

Grupo de Educação para a Morte: uma Estratégia Complementar à Formação Acadêmica do Profissional de Saúde

Resumo Os cursos de Educação para a Morte têm sido propostos como uma tentativa de preencher uma lacuna importante da formação acadêmica na área da saúde, trazendo à tona temas que, frequentemente, são negligenciados no ensino, como o processo de morrer, atitudes frente à morte, cuidados paliativos, luto do profissional, dentre outros. Esses cursos necessitam ter objetivos claramente definidos, configurando uma proposta pedagógica que busca introduzir uma postura humanista e humanizada em cursos fortemente tecnicistas. O objetivo deste estudo é descrever uma experiência de implementação do Grupo de Educação para a Morte e conhecer a percepção dos participantes sobre essa experiência. Participaram do estudo oito alunas do último ano de um curso da área de saúde de uma universidade pública, com idades entre 22 e 24 anos. Foi aplicado um questionário autopreenchido, em dois momentos: pré e pós-intervenção. As respostas às questões abertas foram submetidas à análise de conteúdo temática. Constatou-se a importância do grupo como instrumento de aquisição de conhecimentos sobre o manejo de situações de terminalidade, espaço de ressignificação da morte e do morrer, reflexão sobre atitudes, condutas e papel profissional, e mudanças nos sentimentos despertados pelo cuidado de pacientes em estado crítico de saúde.

Sexuality education for health professionals: A literature review

Abstract The objective of this study was to review the scientific literature addressing educational actions related to the training of health professionals in sexuality between 2003 and 2013. The results obtained show that college seniors, recent college graduates, or those working in hospitals and other health care facilities are not adequately prepared to meet patients' needs regarding sexuality. Several studies have shown improvement in the health practitioners' ability to deal with patients' sexuality issues after participating in training programs in sexuality, regardless of the course load. According to the articles reviewed, in order to improve the performance and comfort level of health practitioners to deal with patients' sexuality concerns, investments in educational actions are necessary.

Development of an explanatory model of sexual intimacy following treatment for localised prostate cancer: A systematic review and meta-synthesis of qualitative evidence

RATIONALE

Prostate cancer is a leading cause of cancer in men, affecting one in eight. An ageing population coupled with increased testing indicates that the incidence of early-stage prostate cancer is rising rapidly. Treatments are effective, but all can result in chronic sexual side effects and impact on the psychological, emotional and relational components of sexual functioning. Whilst the physical consequences of treatment are well documented, we lack a comprehensive picture of the effects of localised prostate cancer treatment on men's experience of sexual intimacy and how this may affect survivorship and recovery.

OBJECTIVE

This study synthesises the qualitative literature related to men's experience of sexual intimacy in the context of localised prostate cancer.

METHODS

A systematic search strategy identified 12 studies, which were assessed using a modified version of the Critical Appraisal Skills Programme. Using Noblit and Hare's (1988) approach, a meta-synthesis was conducted.

RESULTS

Findings are organised within four inter-related themes that form the basis of a new conceptual explanatory model: (i) Loss and grief: Destroyed intimacy; (ii) Going through the motions: Artificial intimacy; (iii) Fear of failure: Avoiding intimacy and (iv) Breaking barriers: Constructing an alternative intimacy.

CONCLUSION

The LMAC (Loss, Motions, Avoidance and Construction) model provides a new way of conceptualising sexual recovery following prostate cancer treatment and opportunities for health care professionals to support men and their partners.

IMPACT OF THE EFFECTS OF THE RECONSTRUCTIVE SURGERY IN THE LIFE OF WOMEN WITH BREAST CANCER

This is a descriptive study which aimed to investigate the impact of the effects of reconstructive surgery in the life of women with breast cancer. Semistructured and audiorecorded, interviews were held with 14 women who had had mastectomies, who were registered in a rehabilitation center. Social Representation Theory was used for discussion of the data. Thematic analysis guided the analysis of the data. The categories which emerged from the interviews are related to the way in which the woman sees herself after the reconstruction, and what this meant in her life, and how she perceives its benefits and lives with the resulting limitations. The reconstruction of the breast, in some cases, allowed recovery of self-image and overcoming of the trauma caused by the disease. On the other hand, the postoperative complications gave rise to fear of further loss, fear of compromise in the sexual sphere, and fear in the perception of the reconstructed breast. The health team must offer appropriate information such that the woman may participate in the decisions regarding the operation.